Objective To investigate the effect and safety of different PaO2 to the reoxygenation injury of cyanotic congenital heart disease through controlling the FiO2 when initiating cardiopulmonary bypass (CPB).Methods Thirty patients with cyanotic congenital heart disease were divided into 3 equal groups according the PaO2 when initiating cardiopulmonary bypass:group 1 (G1,PaO2 ＜ 120 mm Hg) ; group 2 (G2,PaO2 120-180 mm Hg),group 3 (G3,PaO2 180-250 mm Hg),and ten patients with acyanotic congenital heart disease were group 4 (G4,PaO2 ＞ 200 mm Hg).Serum CK-MB,cTnI,IL-6,TNF-α,SOD,8-ISO and S100β were measured before CPB、5 minute after CPB,10 minute after CPB,5 minute after cross clamp releasing,2 hours and 24 hours post operation with intemal jugular vein blood samples.Clinical results were also recorded.Results CK-MB,cTnI,IL-6,TNF-α,8-ISO and S100β3 were all normal without significant differences between them before CPB.After initiation of CPB,their levels in all groups increased,reached the peak before or after the stop of CPB,then gradually declined.At each time point,the levels of these indexes were G3 ＞ G2 ＞ G1 ＞ G4 with significant difference between them (P ＜ 0.05) ; The serum SOD levels of G4 were higher than the other three groups with significant difference(P ＜ 0.05).They all declined after initiation of CPB,reached lowest after cross clamp releasing,then gradually increased.At 5 minute after CPB,10 minute after CPB,5 minute after cross clamp releasing,2 hours post operation,there were significant differences between four groups (P ＜ 0.05),and at 24 hours post operation,the SOD levels of G4 were higher than the other three groups with significant difference (P ＜ 0.05).There were no significant difference between G1,G2 and G3 in SvO2,Lac,positive vasoactive drugs、ventilation time and ICU time.All patients were alive.Conclusion Low reoxygenation concentration can reduce the reoxygenation injury of cyanotic congenital heart disease,though there may be some potential influence to cerebral oxygen metabolism.Further studies about oxygen supplymethodsare necessary in deep hypothermia and long-time CPB.

OBJECTIVE:To analyze the utilization and variation tendency of oral hypoglycemic agents in Wuhan area,and to provide reference for drug selection and enterprise production and sale. METHODS:The utilization of oral hypoglycemic agents in 34 hospitals from Wuhan area during 2011-2013 was analyzed statistically in respects of consumption sum,DDDs and DDC etc. RESULTS:The consumption sum and DDDs of oral hypoglycemic agents increased by 20% and 7% respectively year by year. Acarbose had a market share of over 40%. The drug use frequency of metformin ranked the second place only to acarbose. DPP-4 inhibitor had a promising future,with a consumption sum proportion of more than 10%,while the market share of traditional Chi-nese medicine had fallen below 3%. Except for repaglinide,gliclazide,glimepiride,Xiaoke pills,etc.,the selling of other medica-tions are consistent with the user. CONCLUSIONS:The utilization of oral hypoglycemic drugs is basically rational in 34 hospitals from Wuhan area during 2011-2013.

Neuroimaging technology is the major means in the study of cerebral blood flow. This article reviews all kinds of neuroimaging technologies in identification of perihematomal penumbra in intracerebral hemorrhage,as well as the research status of perihematomal cerebral blood flow in intracerebral hemorrhage.

Cardiovascular disease is a severe threat to human health and life. Among many risk factors of cardiovascular disease, genetic or gene-based ones are drawing more and more attention in recent years. Accumulated evidence has demonstrated that the loss or mutation of ataxia telangiectasia mutated (ATM) gene can result in DNA damage repair dysfunctions, telomere shortening, decreased antioxidant capacity, insulin resistance, increased lipid levels, etc., and thus can promote the occurrence of cardiovascular risk factors, such as aging, atherosclerosis and metabolic syndrome. In this review, we discusses the possible mechanisms between ATM gene and cardiovascular risk factors, which could be helpful to the related research and clinical application.
Aging ; Ataxia Telangiectasia Mutated Proteins ; genetics ; Cardiovascular Diseases ; genetics ; DNA Damage ; DNA Repair ; Humans ; Mutation ; Risk Factors

Objective　To study the MRI signs in spinal cord injury. Methods　A tatal of 90 cases of spinal cord injury examined with magnetic resonance(MR)，40 underwent a GE 0.5T superconducting system and 50 with a SIEMENS Open 0.2T. With spine surface coil, all of them were examined with axial and sagittal spin echo sequences, while 10 given extra coronal sequence. MRI findings and its correlation with prognosis of patients were analyzed. Results　Among the 90 cases of spinal cord injury, incomplete and complete transection of spinal cord was found in 14 cases (13.2%), spinal cord edema in 11 (10.4%), intraspinal cord hemorrhage in 27 (25.5%), compression and dislocation in 27(25.5%), malacia in 16(15.1%), and atrophy in 11(10.4%). Conclusion　From the morphologic and pathological changes of spinal cord MRI can not only direct the option of treatment protocols, but may also evaluate the prognosis of spinal cord injuries. Demonstrated by MRI, it suggests that.

Aged ; Drug Resistance, Bacterial ; Humans ; Intensive Care Units ; Male ; Microbial Sensitivity Tests ; Pneumoconiosis ; microbiology ; Sputum ; microbiology

Objective To establish the surgical landmarks of the endoscopic endonasal approach to the ventral region of middle-lower part of clivus and provide anatomic basis. Methods Twenty 10% formalin-fixed intact adult head specimens were used to dissect and observe the anatomic feature of this access in order to establish the surgical landmarks of the approach, and some relative anatomic data were measured. Five fresh and intact head specimens injected with colored latex were used, and completely analogical operation via endoscopic endonasal approach to the middle-lower part of clivus was performed in all cases. Results Anatomic landmarks of the approach included middle turbinate, choana narium, eustachian tube ostium, nasopharynx mucosa, longus capitis and longus colli, pharyngeal tubercle, and basi-on. To expose the ventral region of middle-lower part of clivus completely, the shortest distance was ( 89.60 ± 2. 52) mm. The ranges of stripping the inferior wall of sphenoid sinus and the lower clivus were bounded by pterygoid canal and foramen lacerum, and the distances from the median line were (9. 37 ± 0.59) mm and (10. 75 ± 0. 63 ) mm, respectively. Conclusions The structures of the ventral middle-lower part of clivus can be revealed sufficiently via an endoscopic endonasal approach.

Purpose To investigate the MRI characteristics and differential diagnosis of intraventricular meningioma. Materials and Methods The clinical manifestation and MRI characteristics was retrospectively analyzed in the 11 patients with confirmed intraventricular meningioma by pathology. Results The intraventricular fibrocellular meningioma (7 cases) showed iso- and slightly short T1 signal and short and heterogeneously iso-T2 signal. The syncytial (1 case) and mixed (1 case) miningioma in the fourth ventricle, the syncytial meningioma in the third ventricle, and endothelial meningioma in the septum pellucidum (1 case) all showed slightly long T1 and slightly long T2 signal. Pathology results showed that 7 cases of fibrocellular meningioma in lateral ventricle, 1 case of syncytial meningioma and mixed type in the fourth ventricle, 1 case of syncytial meningioma in the third ventricle, 1 case of endothelial meningioma in septum pellucidum Conclusion The fibrocellular type was commonly encountered for the lateral ventricle meningioma, and hypointensity on T2WI could be regarded as its typical MRI characteristics, and it is diffcult for the differential diagnosis for the other intraventrical meningiomas.

BACKGROUND:Bone marrow mesenchymal stem cells have potential to self-renewal and multi-lineage differentiation. But after a long period of culture in vitro, the proliferation and differentiation capacities of bone marrow mesenchymal stem cells gradual y loss, the mechanism underlying which is not clear now.
OBJECTIVE:To observe the expression of autophagy-related gene Beclin-1 in differentiation from human bone marrow mesenchymal stem cells into neuron-like cells in vitro.
METHODS:The changes of morphological characteristics of neuron-like cells differentiated from human bone marrow mesenchymal stem cells induced by epidermal growth factor were observed. The expression of neuron-specific enolase and glial fibril ary acidic protein in treated and untreated human bone marrow mesenchymal stem cells were detected using immunocytochemistry. The Beclin-1 protein expressions were detected by western blot before and after induction.
RESULTS AND CONCLUSION:After being induced, human bone marrow mesenchymal stem cells presented classical neuron-like morphology;the expressions of neuron-specific enolase and glial fibril ary acidic protein were 78.7%and 8.1%, respectively. The expression of Beclin-1 protein was changed correspondingly during the induction, which increased after 30 minutes of induction and decreased gradual y after 1 hour of induction. Human bone marrow mesenchymal stem cells could be induced into neuron-like cells in vitro by epidermal growth factor. Autophagy-related gene was highly expressed in the induction of early differentiation and the expression gradual y reduced until it remained at a low level during the differentiation.

Objective To study the validity of furosemide test for predicting the hematoma enlargement in pa- tients with hypertensive cerebral hemorrhage.Methods Four hundred fifty-one patients with hypertensive cerebral hemorrhage were diagnosed using CT after oneset of the disease and 24 h reexamined 24 h after.The incidence of enlarged hematoma was evaluated by comparison the baseline and 24 h CT scanning.Furosemide(20 mg iv)was ad- ministered and blood pressure was measured 30 min after furosemide.Results The decreasing level of MAP after furosemide was significantly inversely related with incidence rate of hematoma enlargement{ r=-0.94,t=58.4,P 10 mmHg as the cut-off point,with the rate of hematoma enlargement as being 6.4 %,MAP decreased≤10 mmHg was associated with increases in prevalence of hematome to 33.2 %(?~2=51.82, P